Addressing musculoskeletal health inequity in Africa

Adebajo, Ade; Gabriel, Sherine E.

doi:10.1002/acr.20032

Cited by 26 publications

(14 citation statements)

References 13 publications

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“…[8] Furthermore, the burden of MSK disorders in terms of DALYs in the developing world (21 076 000 DALYs) is estimated to be almost 2.5 times that in the developed world (8 723 000 DALYs). [6] For SLE, survival rates in developing countries are significantly lower than those reported in developed countries such as the USA, Western Europe and Canada, where 5-and 10-year survival rates surpass 90%. [9] In South Africa (SA), the 5-year survival rate was shown to be between 57% and 72% (1986 -2003) in a case series of 226 SLE patients.…”

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confidence: 94%

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confidence: 99%

“…[6] This is against the background of MSK disorders contributing only 3.4% and 1.7% of the total disease burden in the developed and developing world, respectively. [6] Osteoarthritis and low back pain remain the largest contributors to the global disability burden. [6] The Bone and Joint Decade 2000 -2010, endorsed by many organisations including the World Health Organization (WHO) and many governments, has acknowledged the rising burden of MSK disorders.…”

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confidence: 99%

“…[6] Osteoarthritis and low back pain remain the largest contributors to the global disability burden. [6] The Bone and Joint Decade 2000 -2010, endorsed by many organisations including the World Health Organization (WHO) and many governments, has acknowledged the rising burden of MSK disorders. [7] In 2013, the Global Burden of Disease (GBD) study showed that the proportion of disabilityadjusted life-years (DALYs) caused by years lost due to disability (YLD) increased globally from 21.1% in 1990 to 31.2% in 2013.…”

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confidence: 99%

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Musculoskeletal disorders – disease burden and challenges in the developing world

Gcelu

Kalla

2015

S Afr Med J

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confidence: 94%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Musculoskeletal disorders – disease burden and challenges in the developing world

Gcelu

Kalla

2015

S Afr Med J

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“…While this may not appear to be one of the priorities for the industrialized world, it behooves the international rheumatology community to collaborate and support Africa in its efforts to find answers to these clinical conundrums 20 . The benefits will be for all!…”

Section: Rheumatologymentioning

confidence: 99%

The Scourge of HIV Infection in Sub-Saharan Africa — A Rheumatological Perspective

Tikly¹

2011

J Rheumatol

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Perceptions and Challenges Experienced by African Physicians When Prescribing Methotrexate for Rheumatic Disease: An Exploratory Study

Hitchon

Mody

Feldman

et al. 2021

ACR Open Rheumatology

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Objective Guidelines for methotrexate (MTX) use in rheumatic disease may not be feasible for physicians practicing in the least developed countries. We aimed to understand the experiences of MTX prescribers relating to MTX use for rheumatic disease in African countries to inform the development of culturally and geographically appropriate recommendations. Methods African physicians who self‐identified as MTX prescribers from countries classified as having a low versus a medium or high Human Development Index (L‐HDI versus MH‐HDI) participated in semistructured interviews between August 2016 and September 2017. Interviews were transcribed verbatim, coded thematically, and stratified by HDI. Results Physicians (23 rheumatologists; six internists) from 29 African countries were interviewed (15 L‐HDI; 14 MH‐HDI). Identified barriers to MTX use included inconsistent MTX supply (reported by 87% L‐HDI versus 43% MH‐HDI), compounded by financial restrictions (reported by 93% L‐HDI versus 64% MH‐HDI), patient hesitancy based partly on cultural beliefs and societal roles (reported by 71%), few prescribers (reported by 33%), prevalent infections (especially viral hepatitis, tuberculosis, and human immunodeficiency virus), and both availability and cost of monitoring tests. MTX pretreatment evaluation and starting and maximal doses were similar between L‐HDI countries and MH‐HDI countries. Conclusion The challenges of treating rheumatic disease in African countries include unreliable drug availability and cost, limited subspecialists, and patient beliefs. Adapting recommendations for MTX use in the context of prevalent endemic infections; ensuring safe but feasible MTX monitoring strategies, enhanced access to stable drug supply, and specialized rheumatology care; and improving patient education are key to reducing the burden of rheumatic diseases in L‐HDI countries.

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Addressing musculoskeletal health inequity in Africa

Cited by 26 publications

References 13 publications

Musculoskeletal disorders – disease burden and challenges in the developing world

Musculoskeletal disorders – disease burden and challenges in the developing world

The Scourge of HIV Infection in Sub-Saharan Africa — A Rheumatological Perspective

Perceptions and Challenges Experienced by African Physicians When Prescribing Methotrexate for Rheumatic Disease: An Exploratory Study

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